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PHARMAC has recently updated the Prescription for Pharmacoeconomic Analysis (PFPA)—the document that outlines the methods PHARMAC uses when conducting cost-utility analysis (CUA). The updated document is available athttp://www.pharmac.govt.nz/2012/06/26/PFPAFinal.pdf1The PFPA has high importance to PHARMAC as it describes the approach we take when doing CUA. PHARMAC uses CUA to compare the cost-effectiveness of a pharmaceutical with other pharmaceuticals that could be funded instead. CUA is a form of cost-effectiveness analysis that considers the impact of treatment on patients' quality of life as well as length of life. In addition, PHARMAC CUAs also include effects elsewhere on the New Zealand health sector, such as potential savings from reduced hospitalisations that may occur as a result of funding a pharmaceutical.2 This type of analysis is imperative, as cost-effectiveness is one of nine decision criteria that PHARMAC uses to make funding decisions.3The first version of the PFPA was drafted in 1999, and a revised second version was published in 2007 (PFPA Version 2.0).4 Subsequently a number of its recommendations have been reviewed, and several minor changes have been made to the second version. These changes are documented in Appendix 1 of the updated PFPA.1The key amendment to the PFPA is that results of CUAs are to be reported using incremental utility cost ratios (IUCRs),5 i.e. the incremental quality-adjusted life year (QALY) gains per unit net cost.6 These reflect the opportunity cost of investment decisions when operating within a fixed budget,7,8 and are expressed as QALYs per $1 million of the total budget invested (see Footnote *).In addition to this amendment, version 2.1 of the PFPA provides further information on factors to consider when critically appraising clinical trials and the transformation of clinical evidence in economic modelling.PHARMAC will continue to review and update its methodology for undertaking cost-utility analysis. We welcome any further feedback. Rachel Grocott (rachel.grocott@pharmac.govt.nz Senior Health Economist Scott Metcalfe Chief Advisor Population Medicine / Deputy Medical Director (Epidemiology) PHARMAC, Wellington

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Rachel Grocott, Senior Health Economist, Scott Metcalfe, Chief Advisor Population Medicine / Deputy Medical Director (Epidemiology), PHARMAC, Wellington

Acknowledgements

Correspondence

Correspondence Email

rachel.grocott@pharmac.govt.nz

Competing Interests

Prescription for Pharmacoeconomic Analysis: methods for cost-utility analysis, Version 2.1. PHARMAC: Wellington, New Zealand, 2012. http://www.pharmac.govt.nz/2012/06/26/PFPAFinal.pdfMetcalfe S, Dougherty S, Brougham M, Moodie P. PHARMAC measures savings elsewhere to the health sector. N Z Med J. 2003;116:U362. http://journal.nzma.org.nz/journal/116-1170/362/PHARMAC. Operating policies and procedures of the Pharmaceutical Management Agency (cPHARMACd), Third Edition, January 2006. http://www.pharmac.govt.nz/2005/12/22/231205.pdfGrocott R, Metcalfe S. PHARMAC's updated guidelines for cost-effectiveness analyses, with new discount rate. N Z Med J. 2007;120:U2641. http://journal.nzma.org.nz/journal/120-1258/2641/Craig BA, Black MA. Incremental cost-effectiveness ratio and incremental net-health benefit: two sides of the same coin. Expert Rev Pharmacoecon Outcomes Res. 2001;1:37-46. http://www.expert-reviews.com/doi/pdf/10.1586/14737167.1.1.37Metcalfe S, Rodgers A, Werner R, Schousboe C. PHARMAC has no cost-effectiveness threshold. N Z Med J. 2012;125:99-101. http://journal.nzma.org.nz/journal/125-1350/5083/Metcalfe S, Grocott R. Comments on \"Simoens, S. Health economic assessment: a methodological primer. Int. J. Environ. Res. Public Health 2009, 6,2950-2966\"New Zealand in fact has no cost-effectiveness threshold. Int J Environ Res Public Health. 2010;7:1831-4. http://www.mdpi.com/1660-4601/7/4/1831/Grocott R. Applying Programme Budgeting Marginal Analysis in the health sector: 12 years of experience. Exp Rev Pharmacoecon Outcomes Res. 2009;9:181-7 http://www.expert-reviews.com/doi/abs/10.1586/erp.09.2Zethraeus N, Johannesson M, J 00f6nsson B, L 00f6thgren M, Tambour M. Advantages of using the net-benefit approach for analysing uncertainty in economic evaluation studies. Pharmacoeconomics. 2003;21:39-48.http://adisonline.com/pharmacoeconomics/Abstract/2003/21010/Advantages_of_Using_the_Net_Benefit_Approach_for.3.aspx

Contact diana@nzma.org.nz
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PHARMAC has recently updated the Prescription for Pharmacoeconomic Analysis (PFPA)—the document that outlines the methods PHARMAC uses when conducting cost-utility analysis (CUA). The updated document is available athttp://www.pharmac.govt.nz/2012/06/26/PFPAFinal.pdf1The PFPA has high importance to PHARMAC as it describes the approach we take when doing CUA. PHARMAC uses CUA to compare the cost-effectiveness of a pharmaceutical with other pharmaceuticals that could be funded instead. CUA is a form of cost-effectiveness analysis that considers the impact of treatment on patients' quality of life as well as length of life. In addition, PHARMAC CUAs also include effects elsewhere on the New Zealand health sector, such as potential savings from reduced hospitalisations that may occur as a result of funding a pharmaceutical.2 This type of analysis is imperative, as cost-effectiveness is one of nine decision criteria that PHARMAC uses to make funding decisions.3The first version of the PFPA was drafted in 1999, and a revised second version was published in 2007 (PFPA Version 2.0).4 Subsequently a number of its recommendations have been reviewed, and several minor changes have been made to the second version. These changes are documented in Appendix 1 of the updated PFPA.1The key amendment to the PFPA is that results of CUAs are to be reported using incremental utility cost ratios (IUCRs),5 i.e. the incremental quality-adjusted life year (QALY) gains per unit net cost.6 These reflect the opportunity cost of investment decisions when operating within a fixed budget,7,8 and are expressed as QALYs per $1 million of the total budget invested (see Footnote *).In addition to this amendment, version 2.1 of the PFPA provides further information on factors to consider when critically appraising clinical trials and the transformation of clinical evidence in economic modelling.PHARMAC will continue to review and update its methodology for undertaking cost-utility analysis. We welcome any further feedback. Rachel Grocott (rachel.grocott@pharmac.govt.nz Senior Health Economist Scott Metcalfe Chief Advisor Population Medicine / Deputy Medical Director (Epidemiology) PHARMAC, Wellington

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Rachel Grocott, Senior Health Economist, Scott Metcalfe, Chief Advisor Population Medicine / Deputy Medical Director (Epidemiology), PHARMAC, Wellington

Acknowledgements

Correspondence

Correspondence Email

rachel.grocott@pharmac.govt.nz

Competing Interests

Prescription for Pharmacoeconomic Analysis: methods for cost-utility analysis, Version 2.1. PHARMAC: Wellington, New Zealand, 2012. http://www.pharmac.govt.nz/2012/06/26/PFPAFinal.pdfMetcalfe S, Dougherty S, Brougham M, Moodie P. PHARMAC measures savings elsewhere to the health sector. N Z Med J. 2003;116:U362. http://journal.nzma.org.nz/journal/116-1170/362/PHARMAC. Operating policies and procedures of the Pharmaceutical Management Agency (cPHARMACd), Third Edition, January 2006. http://www.pharmac.govt.nz/2005/12/22/231205.pdfGrocott R, Metcalfe S. PHARMAC's updated guidelines for cost-effectiveness analyses, with new discount rate. N Z Med J. 2007;120:U2641. http://journal.nzma.org.nz/journal/120-1258/2641/Craig BA, Black MA. Incremental cost-effectiveness ratio and incremental net-health benefit: two sides of the same coin. Expert Rev Pharmacoecon Outcomes Res. 2001;1:37-46. http://www.expert-reviews.com/doi/pdf/10.1586/14737167.1.1.37Metcalfe S, Rodgers A, Werner R, Schousboe C. PHARMAC has no cost-effectiveness threshold. N Z Med J. 2012;125:99-101. http://journal.nzma.org.nz/journal/125-1350/5083/Metcalfe S, Grocott R. Comments on \"Simoens, S. Health economic assessment: a methodological primer. Int. J. Environ. Res. Public Health 2009, 6,2950-2966\"New Zealand in fact has no cost-effectiveness threshold. Int J Environ Res Public Health. 2010;7:1831-4. http://www.mdpi.com/1660-4601/7/4/1831/Grocott R. Applying Programme Budgeting Marginal Analysis in the health sector: 12 years of experience. Exp Rev Pharmacoecon Outcomes Res. 2009;9:181-7 http://www.expert-reviews.com/doi/abs/10.1586/erp.09.2Zethraeus N, Johannesson M, J 00f6nsson B, L 00f6thgren M, Tambour M. Advantages of using the net-benefit approach for analysing uncertainty in economic evaluation studies. Pharmacoeconomics. 2003;21:39-48.http://adisonline.com/pharmacoeconomics/Abstract/2003/21010/Advantages_of_Using_the_Net_Benefit_Approach_for.3.aspx

Contact diana@nzma.org.nz
for the PDF of this article

View Article PDF

PHARMAC has recently updated the Prescription for Pharmacoeconomic Analysis (PFPA)—the document that outlines the methods PHARMAC uses when conducting cost-utility analysis (CUA). The updated document is available athttp://www.pharmac.govt.nz/2012/06/26/PFPAFinal.pdf1The PFPA has high importance to PHARMAC as it describes the approach we take when doing CUA. PHARMAC uses CUA to compare the cost-effectiveness of a pharmaceutical with other pharmaceuticals that could be funded instead. CUA is a form of cost-effectiveness analysis that considers the impact of treatment on patients' quality of life as well as length of life. In addition, PHARMAC CUAs also include effects elsewhere on the New Zealand health sector, such as potential savings from reduced hospitalisations that may occur as a result of funding a pharmaceutical.2 This type of analysis is imperative, as cost-effectiveness is one of nine decision criteria that PHARMAC uses to make funding decisions.3The first version of the PFPA was drafted in 1999, and a revised second version was published in 2007 (PFPA Version 2.0).4 Subsequently a number of its recommendations have been reviewed, and several minor changes have been made to the second version. These changes are documented in Appendix 1 of the updated PFPA.1The key amendment to the PFPA is that results of CUAs are to be reported using incremental utility cost ratios (IUCRs),5 i.e. the incremental quality-adjusted life year (QALY) gains per unit net cost.6 These reflect the opportunity cost of investment decisions when operating within a fixed budget,7,8 and are expressed as QALYs per $1 million of the total budget invested (see Footnote *).In addition to this amendment, version 2.1 of the PFPA provides further information on factors to consider when critically appraising clinical trials and the transformation of clinical evidence in economic modelling.PHARMAC will continue to review and update its methodology for undertaking cost-utility analysis. We welcome any further feedback. Rachel Grocott (rachel.grocott@pharmac.govt.nz Senior Health Economist Scott Metcalfe Chief Advisor Population Medicine / Deputy Medical Director (Epidemiology) PHARMAC, Wellington

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Rachel Grocott, Senior Health Economist, Scott Metcalfe, Chief Advisor Population Medicine / Deputy Medical Director (Epidemiology), PHARMAC, Wellington

Acknowledgements

Correspondence

Correspondence Email

rachel.grocott@pharmac.govt.nz

Competing Interests

Prescription for Pharmacoeconomic Analysis: methods for cost-utility analysis, Version 2.1. PHARMAC: Wellington, New Zealand, 2012. http://www.pharmac.govt.nz/2012/06/26/PFPAFinal.pdfMetcalfe S, Dougherty S, Brougham M, Moodie P. PHARMAC measures savings elsewhere to the health sector. N Z Med J. 2003;116:U362. http://journal.nzma.org.nz/journal/116-1170/362/PHARMAC. Operating policies and procedures of the Pharmaceutical Management Agency (cPHARMACd), Third Edition, January 2006. http://www.pharmac.govt.nz/2005/12/22/231205.pdfGrocott R, Metcalfe S. PHARMAC's updated guidelines for cost-effectiveness analyses, with new discount rate. N Z Med J. 2007;120:U2641. http://journal.nzma.org.nz/journal/120-1258/2641/Craig BA, Black MA. Incremental cost-effectiveness ratio and incremental net-health benefit: two sides of the same coin. Expert Rev Pharmacoecon Outcomes Res. 2001;1:37-46. http://www.expert-reviews.com/doi/pdf/10.1586/14737167.1.1.37Metcalfe S, Rodgers A, Werner R, Schousboe C. PHARMAC has no cost-effectiveness threshold. N Z Med J. 2012;125:99-101. http://journal.nzma.org.nz/journal/125-1350/5083/Metcalfe S, Grocott R. Comments on \"Simoens, S. Health economic assessment: a methodological primer. Int. J. Environ. Res. Public Health 2009, 6,2950-2966\"New Zealand in fact has no cost-effectiveness threshold. Int J Environ Res Public Health. 2010;7:1831-4. http://www.mdpi.com/1660-4601/7/4/1831/Grocott R. Applying Programme Budgeting Marginal Analysis in the health sector: 12 years of experience. Exp Rev Pharmacoecon Outcomes Res. 2009;9:181-7 http://www.expert-reviews.com/doi/abs/10.1586/erp.09.2Zethraeus N, Johannesson M, J 00f6nsson B, L 00f6thgren M, Tambour M. Advantages of using the net-benefit approach for analysing uncertainty in economic evaluation studies. Pharmacoeconomics. 2003;21:39-48.http://adisonline.com/pharmacoeconomics/Abstract/2003/21010/Advantages_of_Using_the_Net_Benefit_Approach_for.3.aspx

Contact diana@nzma.org.nz
for the PDF of this article

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